By Dr. Dave Hnida

(CBS4) – Over the past month or so, more and more cases of unusual rashes have been popping up in people — rashes or skin lesions that many physicians now believe may be related to coronavirus. One of those skin conditions is something nicknamed “COVID toes,” a redness or inflammation of the toes or soles of the feet.

In many ways, COVID toes resembles a mild case of frostbite. They generally show up in people under age 40, most of whom have tested positive for coronavirus. Yet, they are generally not too ill.

In some instances, the rash shows up before respiratory symptoms or fever; in other cases, it shows up afterwards. And even in situations, it shows up in people who never become clinically ill, and wind up testing negative for COVID-19.


(credit: American Academy of Dermatology)

And it’s not just the frostbite or purple marks that show up on the feet. There are also reports of COVID patients developed a fine, lacelike rash over the body, some have developed hives, still others have developed chickenpox type lesions.

So what’s behind rashes and other skin lesions with this virus? Experts aren’t sure. Some say it’s part of the body’s immune response to getting, or fighting off an illness. Others say it may be related to inflammation of very small blood vessels or micro clots in the feet or elsewhere on the body.

I’ve even seen some cases of unusual rashes or redness of the toes, which at first, didn’t seem like any big deal. But now with COVID 19 as a possible cause, the red flag has gone up.

Many dermatologists are recommending coronavirus tests in people with weird skin lesions, even if they are feeling fine. Yet a few are saying, if a person has no other symptoms, just take a wait and see approach. After all, it’s not unusual to have any virus trigger a skin rash, especially some of the spring time viruses, and most will disappear within 2-3 weeks.

My advice: if you do wind up getting “COVID toes” or some other skin rash, it is probably a good idea to check in with your health care provider to decide what to do next. And, if you have even some mild symptoms otherwise, like a cough, chills, or stomach issues, self-isolation is a good idea until you are advised about what you need to do next.

Dr. Dave Hnida

  1. Dr. Seheult (Medcram channel on Youtube) speculates that COVID toes are a manifestation of thrombosis (blood clots), which may be the most dangerous aspect of COVID-19 and responsible for most deaths.

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